GRAND PALACE HOTEL
RIGA - LATVIA
Pits street 12 • Riga • LV 1050 • Latvia
www.grandpalaceriga.com
CREDIT CARD AUTHORISATION FORM
Reservation for:
Reservation from:
Reservation until:
Reservation Nr.
I authorize Wad Grand Police" bd. (Pits street 12, Riga, Latvia, VAT reg. nr. LV40003378078) to charge the
amount of EUR from the below mentioned credit card for all requested services.*
Type of Credit Cant
Credit Card Number:
Cryptogram number (CVC):
Expiry date:
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*Request cannot be processed without a legible front and back side copy of the credit card.
Holder's signature:
Date:
Company stamp:
(if applicable)
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